| NPI | 1720558554 |
|---|---|
| Former Name | MEGAN MARIE LONGSHORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.026496) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-12-05 |
| Last Update Date | 2024-02-09 |